Mao, H., Mao, J.J., Guo, M., Cheng, K., Wei, J., Shen, X., & Shen, X. (2016). Effects of infrared laser moxibustion on cancer-related fatigue: A randomized, double-blind, placebo-controlled trial. Cancer, 122, 3667–3672. 

To evaluate the safety and efficacy of laser moxibustion for cancer-related fatigue

Moxibustion is a modality of acupuncture that involves burning the herb Artemisia vulgaris on or above the skin at acupoints. This provides heat stimulation instead of stimulation by needles. Infrared laser moxibustion is an approach using laser devices to irradiate acupoints at about 2 cm away from the skin's surface. Patients were randomly assigned to receive real or sham laser moxibustion for 20 minutes three times per week for four weeks. The laser operator was blinded; because the infrared laser is colorless, neither the operator nor the patient could see it. For the sham group, the laser source was turned off. Fatigue was measured at baseline and at weeks 2, 4, and 8.

• N = 61   
• MEAN AGE = 59.3 years
• MALES: 46.1%, FEMALES: 53.9%
• CURRENT TREATMENT: Chemotherapy, radiation, combination radiation and chemotherapy
• KEY DISEASE CHARACTERISTICS: Multiple tumor types—breast, lung, and gastrointestinal were more prevalent.
• OTHER KEY SAMPLE CHARACTERISTICS: The majority were undergoing current treatment; 35.9% were in the survivorship phase after curative treatment. Baseline fatigue was 4.5; 5.03 was the average across groups.

• SITE: Single site   
• SETTING TYPE: Not specified    
• LOCATION: China

PHASE OF CARE: Multiple phases of care

Double-blind, sham-controlled, randomized, controlled trial

Brief Fatigue Inventory (BFI), Chinese version

At week 2, the fatigue score in the moxibustion group was lower (3.8 versus 4.7, Cohen’s d = 0.685, p = 0.044). At week 4, fatigue was also lower in the moxibustion group (3.01 versus 4.40, Cohen's d = 1.14, p = 0.002), and at week 8, the moxibustion group had lower fatigue as well (3.03 versus 4.26, Cohen's d = 0.886, p = 0.006).  No serious adverse events were reported.

The findings suggest that laser moxibustion may be helpful in relieving cancer-related fatigue.

• Small sample (< 100)
• Subject withdrawals ≥ 10% 
• The dropout rate was over 20% but mostly because of disease progression.
• The follow-up period was relatively short.

Laser moxibustion may be another option to combat cancer-related fatigue. This is a painless, noninvasive intervention that warrants further investigation.